Thanks to @ELSOOrg for awarding a “Best Abstract” to our case series. And thanks to our Twitter-less surgeons for allowing me to be the ‘hype man’ for their technique. Here’s to many more! #ELSO2022

Day 3 of @HoustonShockHSS talking about the importance of shock coordinators, maintaining the financial wellbeing of a shock center, and navigating the emotional wellbeing of the patient, caregivers, and providers. @JonathanEmling @StavrosDrakos @FilioBillia @CardioNerds

The role of the shock coordinator… does your program have one? @HoustonShockHSS #HSS2025

Transfer to Hub Hospitals and Outcomes in Cardiogenic Shock #AHAJournals @JiwonKimMD @kaznegishi @navinkapur4 @JDawnAbbott1 @tonkhueMdPhd @ShubhaPawar @KannuBansalMD @SarasVallabhMD ahajournals.org/doi/10.1161/…

Mixed cardiogenic shock (CS) -herein classified as CS with at least 1 additional contributing cause of shock state- is common (& usually quite challenging to treat...) 20% of all shock patients admitted to contemporary cardiac ICUs have mixed CS Besides this old-school approach

Repeat after me: pressure is not flow.

Read the July Issue! loom.ly/Vuu8qGQ In the issue #ECMO #LVAD #RVAD #RespiratoryFailure #SystematicReview #PedsECMO #PedsVAD #LungTx #COVID19 #FREE articles

Congrats to Danger team @CHassager! Impressive results, now after SHOCK and Culprit-Shock 3rd positive RCT. Nevertheless, multiple questions remain: 1) is it the device? 2) patient selection? 3) treatment bias? 4) longer follow-up? @seanvandiepen @JBauersachsMD @NavinKapur4

Consider the prognostic importance of age in decisions surrounding initiation of VV #ECMO, even among relatively young patients! Analysis of @ELSOOrg Registry (2017-2022) among adults with acute respiratory failure #FOAMcc on @yourICM 🔓 rdcu.be/dzcdZ Increasing age strongly/independently associated with higher mortality & risk of complications; risk emerges as early as 30 years

26-year-old Sydney faced a near-death experience from an infection and kidney stones. Her doctors knew she needed ECMO treatment, so she was transferred to Ascension Saint Thomas Hospital West. This treatment gave her life again, and Sydney continues to praise her care team. 💜

🩸Modified 4Ts scoring system in patients on mechanical circulatory support?? 4TMCS probability score, considering type of #MCS (IABP, #ECMO, VAD) demonstrated improved diagnostic accuracy vs 4Ts, and higher sensitivity using the guideline-recommended cutoff.

Dr. Yerokun understands that medication for heart failure may not be an option for you. Take a listen as he shares his expertise on alternative treatments that may be right for you. #HeartMonth

Direct apical #ECMO cannulation, large single (high-volume) center experience showing that technique could be safe & effective in a selected population at institutions with cardiac surgery support @asaiojournal 🖇️ bit.ly/49Iabkf

Novel off-pump direct apical #ECMO cannulation via mini-thoracotomy with dual-lumen cannula @asaiojournal 🖇️ bit.ly/49Iabkf 🫀provides high flow #ECLS with LV decompression (optional) biventricular respiratory support 🫀allows ambulation avoids peripheral artery access-related complications 🫀improves EF, CO/CI & pulmonary artery pressures

Thread: My plea for all #ICU staff: 1. Talk to intubated patients, no matter how old or young.Many of your patients are awake, even if their eyes are closed 2. Always tell them what you’re about to do to them and talk to them while you do it. (1/2) #PedsICU #medtwitter #meded

Left ventricular hemodynamics on VA #ECMO?? Physiology insights from catheterization & 3D echo 🫀 high flow VA #ECLS decompresses LV by significantly ⬇️ LV preload with minimal ⬆️ in afterload 🫀 this ⬇️ LVEDP, LVEDV, LV stroke work, LV PVA #FOAMcc 🔓 bit.ly/47U4Ip5

#TipsForNewDocs Hospitalized patient hasn't walked in days. Wrong: call physical therapy Right: discuss w/bedside nurse if patient stable to mobilize w/nursing staff before calling PT Not every hosp patient needs a PT consult- use this resource wisely. #kittlesonrules

Low cost intervention to improve communication with patients. Place a chair at patient’s bedside and facing the bed:

Ten cognitive check points (general rules or heuristics to help guide my practice) I use in the ICU to help make sure I don't get too far off track. A thread🧵👇 1/10: Shock with a narrow pulse pressure (<30mmHg) needs an urgent #POCUS (or echo) to identify occult RV/LV failure, obstructive shock, or severe hypovolemia. #medtwitter #foamed #echofirst #pocus #MedEd #medicine #FOAMcc